In repeating this process with different pharmacies you will discover there can be quite a spread among even nearby drugstores. Suppose that your ten minutes on phone saves you $20 on your prescription. Then you have just earned money at a rate of $120 per hour each month for your efforts. It is time well spent.

Cost-consciousness is also valuable when it comes to medical tests. If cost of a medical test is prohibitive (as is often case) and you don't have luxury of letting someone else pay for it, then encourage your doctor to talk through your alternatives with you. Does same test cost less at one facility than at another? How important is test? What could go wrong if you skip it, delay it or substitute a less expensive test? What are chances of a serious repercussion?

Unfortunately, your doctor usually has less latitude when cost-optimizing your medical tests, but what could it hurt to ask? You might be glad you did.

And how about optimizing doctor's fee? This is also a fair topic for discussion. When you are considering an appointment with a new doctor it is certainly appropriate to ask for typical fees. However, in current U.S. medical marketplace, doctor's time is usually least expensive component of medical care. The doctor's fee is usually much less than costs of medications and tests. So while it is perfectly reasonable to shop around for affordable doctor fees, when it comes to choosing a doctor, quality issues should come first.

(C) 2005 by Gary Cordingley

One of virtues of MRI pictures is that they are based on physical principles totally different from those responsible for creating CT pictures. Thus, MRI is good (or not so good) at showing different things than CTs. Another virtue is that MRIs can slice and dice brain at different angles, while CTs slices are limited to just horizontal plane. Yet another virtue of MRIs is that they are much better than CTs at imaging most diseases of spine. Finally, MRIs are much more flexible than CTs: new bells, whistles and capabilities are being added all time.

To patient, experiences of having a CT and of having an MRI greatly resemble each other. In both cases patient lies horizontally on a flat table that moves into and out of an opening in scanner that resembles a giant doughnut-hole. The doughnut-hole in MRI machine is narrower, so claustrophobic patients need to inform their doctors if this might be a problem. The MRI machine is also noisier: a loud sound is created each time its radio-frequency coils turn on and off. For each kind of scan technologist might stick a needle in patient's vein to administer contrast-material.

Both tests are otherwise painless and are very safe with certain exceptions. Pregnant women who need a scan might have to do without one for fear of exposing fetus to excessive x-rays in case of CT scan or to an excessive magnetic field in case of MRI. If push comes to shove, woman is more likely to receive a CT scan because her abdomen can be draped with a lead shield that blocks passage of most x-rays, while there is no good method for blocking magnetic field produced by an MRI machine.

A circumstance in which MRIs are simply not done is when patient has a cardiac pacemaker. This is because MRI machine's magnet might disrupt pacemaker and stop heart. No image is so necessary and valuable that this risk would be worth taking. Another circumstance in which an MRI is avoided is when patient is critically ill. An unstable patient can be adequately monitored and supported while receiving a CT scan, but not while receiving an MRI.

Depending on nature of patient's problem, doctor will usually order just one of two types of scans and not other, but in selected cases magic of both kinds of scan might be needed.

(C) 2005 by Gary Cordingley